How much rates vary
Facilitymedian $123 · 10th to 90th $40 to $295Professionalmedian $56 · 10th to 90th $32 to $68
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Facility | None | $60.26 | $60.26 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | None | $56.23 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $29.51 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.31 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
BCBS Michigan Setting Facility Modifier None Typical Low $79.43 Median $194.98 Typical High $371.54 | Facility | None | $79.43 | $194.98 | $371.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | None | $63.10 | $66.07 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $41.69 Typical High $46.77 | Professional | None | $33.88 | $41.69 | $46.77 |
Health Alliance Plan Setting Facility Modifier None Typical Low $50.12 Median $128.82 Typical High $141.25 | Facility | None | $50.12 | $128.82 | $141.25 |
Health Alliance Plan Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $67.61 | Professional | None | $41.69 | $50.12 | $67.61 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
Priority Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Priority Health Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $48.98 | Professional | None | $39.81 | $41.69 | $48.98 |
United Setting Professional Modifier None Typical Low $23.44 Median $30.90 Typical High $47.86 | Professional | None | $23.44 | $30.90 | $47.86 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | KX · Policy requirements met | $53.70 | $53.70 | $53.70 |
BCBS Michigan Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | RR · Rental | $66.07 | $66.07 | $66.07 |
Health Alliance Plan Setting Professional Modifier U4 · State-defined Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | U4 · State-defined | $47.86 | $47.86 | $60.26 |
Where Michigan sits
The same service costs 2.3 times more in Kansas than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 13th of 51
$60.26
KS $79.43AL $33.88
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.